口服胶囊粪菌移植治疗难治性功能性便秘的疗效与安全性评价  

Evaluation of efficacy and safety of oral capsule fecal microbiota transplantation for the treatment of refractory functional constipation

作　　者：张勇[1,2] 张春霞[1] 高戈 张陆一[1] 曾宪东 Zhang Yong;Zhang Chunxia;Gao Ge;Zhang Luyi;Zeng Xiandong(Anorectal Diagnosis and Treatment Center,Shenyang Fourth People’s Hospital,Shenyang 110082,Liaoning,China;Department of Defecation Disorders,Shenyang Anorectal Hospital,Shenyang 110054,Liaoning,China)

机构地区：[1]沈阳市第四人民医院肛肠诊疗中心,辽宁沈阳110082 [2]沈阳市肛肠医院排便障碍科,辽宁沈阳110054

出　　处：《结直肠肛门外科》2024年第3期344-348,共5页Journal of Colorectal & Anal Surgery

基　　金：沈阳市科学技术局公共卫生研发专项(20-205-4-068)。

摘　　要：目的观察口服胶囊粪菌移植治疗难治性功能性便秘的疗效与安全性。方法纳入沈阳市肛肠医院排便障碍科收治的36例接受口服胶囊粪菌移植治疗的难治性功能性便秘患者,统计治疗前、治疗后1个月、治疗后6个月排粪次数>3次/周与粪便性状为Bristol 3或4型的患者例数,并完成慢性便秘严重度评分量表评估、便秘患者生活质量评分量表评估,分析患者的排粪情况和临床疗效,记录治疗及随访期间不良事件。结果粪菌移植治疗前、治疗后1个月、治疗后6个月排粪次数>3次/周的患者例数分别为13例(36.1%)、23例(63.9%)、22例(61.1%),Bristol分型3型或4型的患者例数分别为9例(25%)、24例(66.7%)、16例(44.4%)。粪菌移植治疗后1个月、6个月慢性便秘严重度评分、便秘患者生活质量评分较粪菌移植治疗前低,差异有统计学意义(P<0.05)。粪菌移植后1个月,治愈5例,显效11例,有效11例,无效9例,总有效率为75%;粪菌移植后6个月,治愈6例,显效5例,有效9例,无效16例,总有效率为55.6%,与前者相比,总有效率差异无统计学意义(P>0.999)。根据粪菌移植治疗后6个月的疗效评价结果,分为有效组(n=20)与无效组(n=16),两组性别构成、年龄、泻药依赖史比较差异无统计学意义(P>0.05),无效组病程长于有效组,差异有统计学意义(P<0.05)。所有患者在治疗过程中及治疗后均未发生严重不良反应。2例(5.6%)在治疗期间出现轻度腹痛、腹胀,2例出现轻度腹泻,均可自行缓解。结论口服胶囊粪菌移植治疗难治性功能性便秘有良好的临床效果且安全性较高,其治疗效果与病程相关。Objectives To observe the efficacy and safety of oral capsule fecal microbiota transplantation(FMT)in the treatment of refractory functional constipation.Methods A total of 36 patients with refractory functional constipation admitted to the Department of Defecation Disorders,Shenyang Anorectal Hospital,were enrolled and treated with oral capsule FMT.The number of patients with bowel movements>3 times/week and stool consistency of Bristol type 3 or 4 was recorded before treatment,1 month after treatment,and 6 months after treatment.The Constipation System Score(CSS)and the Patient Assessment of Constipation Quality of Life Score(PAC-Qol)were administered.Analyze the defecation situation and clinical efficacy of patients.Results The number of patients with bowel movements>3 times/week before FMT,1 month after FMT,and 6 months after FMT were 13(36.1%),23(63.9%),and 22(61.1%),respectively.The number of patients with Bristol type 3 or 4 stool consistency were 9(25%),24(66.7%),and 16(44.4%),respectively.The CSS and the PAC-Qol were significantly lower at 1 month and 6 months post-FMT compared to pre-FMT(P<0.05).After 1 month of FMT,5 patients were cured,11 showed marked improvement,11 were effective,and 9 were ineffective,with an overall effective rate of 75%.After 6 months of FMT,6 patients were cured,5 showed marked improvement,9 were effective,and 16 were ineffective,with an overall effective rate of 55.6%.There was no significant difference in the overall effective rate between 1 month and 6 months(P>0.999).Based on the outcomes at 6 months,patients were classified into an effective group(n=20)and an ineffective group(n=16).There was no significant difference in gender composition,age,and history of laxative dependence between the two groups(P>0.05).The course of illness in the ineffective group was longer than that in the effective group,and the difference was statistically significant(P<0.05).No serious adverse reactions occurred during or after FMT.Mild abdominal pain and bloating occurred in 2 patients(5.6%),an

关 键 词：功能性便秘 粪菌移植 临床疗效 

分 类 号：R735.3[医药卫生—肿瘤]